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NPI Code Detail

MEDICARE: MRS. ANN MARIE LUCADO PT, CHT

MEDICARE:  MRS. ANN MARIE LUCADO  PT, CHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251H1200XHand Physical TherapistPT008877GA

General Provider Information

NPI Number : 1528238904
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANN MARIE LUCADO PT, CHT
Provider Business Mailing Address
First Line : 1430 FIVE FORKS TRICKUM RD STE 210
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30044-8183
Country : US
Telephone Number : 678-377-1738
Fax Number : 678-377-1737
Provider Business Practice Location Address
First Line : 1430 FIVE FORKS TRICKUM RD STE 210
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30044-8183
Country : US
Telephone Number : 678-377-1738
Fax Number : 678-377-1737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2008
Last Update Date : 03/03/2008

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Directions to “ MRS. ANN MARIE LUCADO PT, CHT” Practice Location

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